TOTAL PARATHROIDECTOMY WITH AUTOTRANSPLANTATION VERSUS SUBTOTAL PARATHYROIDECTOMY AS DIFFERENT MODALITIES IN MANAGEMENT OF SECONDARY HYPERPARATHYROIDISM

Background: secondary hyperparathyroidism is a common problem in patients with chronic renal failure. The optimal surgery in management of secondary hyperparathyroidism still controversial. Total parathyroidectomy with autotransplantation and subtotal parathyroidectomy may be employed. Methods:This prospective study was conducted on 30 patients presented by manifestations of secondary hyperparathyroidism and admitted to Mansoura University Hospitals over three years (from May 2015 to May 2018).Our patients were divided to two groups: Group (A) included 15 patients underwent total parathyriodectomy with cervical thymectomy and autotransplantation;(TPTX-AT) Group (B) included 15 patients underwent subtotal parathyroidectomy with cervical thymectomy;(SPTX). Results: TPTX-AT was associated with longer operative time than SPTX,(109.6 vs 94.9 p<0.001).the rate of complications was no significantly different between TPTX-AT and SPTX, recurrence of hyperparathyroidism,( SPTX: two patientsvsTPTX-AT: one patient P 1), hypoparathyroidism reported in three patients underwent TPTX-AT vsone patient underwent SPTX p 0.59.The two procedures markedly decreased serum PTH levels to normal ranges. Conclusion: TPTX-AT and SPTX were effectively treating secondary hyperparathyroidism, nearly equal in safety, complications and in biochemical parameters improvement.